Orthopedic brace



W. J. ILLER ORTHOPEDIC BRACE July 3, 1962 Filed Aug. 9, 1955 INVENTOR.

I WERNER J. ILLER ATTORNEYS EfiiZflZd iatented July 3, 1962 3,042,028URTHOPEDIC BRACE Werner J. Iller, Dayton, Ohio, assignor to GlobeIndusn'ies, Inc, Dayton, Ohio, a corporation of Ohio Filed Aug. 9, H55,Ser. No. 527,248 16 Claims. (Cl. 12880) This invention relates toorthopedic braces and particu-larly to orthopedic braces useful inconnection with patients who have become affiicted with cerebral palsyand poliomyelitis.

Cerebral palsy patients particularly in the most serious aspect of theaffliction, tend to retain their capacity for control in the muscles andtendons on the inner side of the legs below the crotch, but verygenerally lose control of the muscles on the adjacent outer sides andaccordingly there is a very great tendency for the knees to cometogether in' a strong scissors action of the legs. Further theaffliction may last for many years, from infancy to the adult stage, andearly training is necessary to enable the afflicted person to attaincontrol of the muscles and to learn to walk. Also adequate orthopedicsupport may be required in the adult years of the trained patient.

A primary object of this invention is to provide an orthopedic bracewhich will position the legs and feet of patients properly during thegrowing and training period.

A particular object of the invention is to provide an orthopedic device,individual parts of which may be replaced as the patient matures and,which device has parts which are readily subject to being mass produced.

An important object of the present invention is the provision of anorthopedic device which provides a minimum of encumbrance to a patientwearing the same while providing a maximum of controlled support.

Another object of the invention is to provide a strong, light weightbrace which is substantially free from mechanical failure.

A specific object of the invention is to provide an orthopedic bracewhich in the condition of use by a patient is effective to provide abiasing action to the legs to tend to cause the knees of the user tomove apart laterally; this permits spreading of the feet in a naturalmanner, assisting training of the patient and encouraging use of musclesand tendons which would not otherwise be employed. Further the spreadingof the feet gives greater support to the patient and aids in attainingbalance.

Yet another object of the invention is to provide an orthopedic bracewhich requires only a minimum of components and also does not requirecross supports between the leg members for completely adequate supportof a user of the brace.

The invention will be more fully understood by reference to thefollowing detailed description and accompanyin g drawings wherein:

FIGURE 1 is a perspective view of an assembled brace constructedaccording to my invention;

FIGURE 2 is a frontal vertical sectional view taken along the left legmember of the brace of FIGURE 1;

FIGURE 3 is a sectional view taken on line 3-3 of FIGURE 2 showing athigh-engaging portion of the brace and which engages the back of theleg above the knee;

FIGURE 4 is a sectional view taken on line 44 of FIGURE 3 showing themanner in which the thigh-engaging portion is provided with rolled edgesto add strength thereto;

FIGURE 5 is a plan view partly broken away showing the construction ofthe waistband of the brace from which the leg members are suspended;

FIGURE 6 is a rear elevational view of the upper portion of the braceshowing the configuration of the waistband assembly;

FIGURE 7 is a perspective view showing a typical device adapted formounting in the patients shoe and for connection with the lower ends ofthe leg members of the brace; and

FIGURE 8 is a fragmentary view showing a modified construction of aportion of a brace in accordance with my 1nvention.

Referring to the drawings somewhat more in detail, the orthopedic braceaccording to the present invention comprises a waistband assemblygenerally indicated at 10 which comprises a back section and forwardlyextending side sections, and leg members generally indicated at 12,which leg members have means at their lower ends 14 for connection witha rigid element to be associated with the patients shoes as referred tohereinafter.

The waistband It) is provided at its opposite sides with brackets 16from which are pivotally suspended the upper leg parts 18; at theirlower ends the leg parts 18 include pivot means 20 to which are attachedthe lower leg parts generally indicated at 22 (FIGURE 2).

According to the present invention, the weight of the brace isminimized, and its efficiency is greatly increased by so forming theparts of the brace that they will be as light as possible whileproviding a high degree of rigidity in those portions that are subjectedto the greatest loading. Further, the brace is adjustable so that thepoints thereof at which pivots occur can be moved to bring the pivotsinto close alignment with the corresponding body joints.

The lightness of the brace is achieved by constructing the metallicparts thereof so that the metal is presented in the most advantageousmanner to sustain the loads imposed thereon. The leg membersaccordingly, are made tubular, thereby presenting the greatestresistance to bending with the least weight.

Similarly, the waistband is made tubular to provide the greateststrength and the lightest weight, and both the waistband and portions ofthe tubular legs are preferably filled with a light plastic materialsuch as isocyanate foam; alternatively, a similarly rigid-like membercan be obtained by forming the waistband from an expanded light metalsuch as a heat-treated aluminum or magnesium honey-comb. Such metalswhich are heat-treated after forming to the desired shape arecommercially available.

In a further embodiment the waistband may be formed by casting theisocyanate foam or a similar plastic foam to the proper rigid shape andthen wrapping the waistband with a resin-impregnated woven fiber glasswrapping which is preferably then plastic coated to provide for a smoothsurface.

The preferred manner of forming the waistband is illustrated in FIGURE 5wherein it will be seen that the waistband comprises two formed thinmetal sheets 24 welded together as at 26; these sheets are very thin".051 aluminum having been found to be very satisfactory. The sheetsdefine an interior spacing and the assembly body is provided with meansfor introducing the filler material such as the apertures 28. Thefunction of the filler is to maintain the thin skins of metal separatedand to insure of rigidity in the waistband. As will be seen in FIGURE 5,the waistband is thickest adjacent the corners thereof which will besubjected to bending stresses so that no greater weight is built intothe waistband than is necessary for the loads applied. The applied loadwhen the structure is in use passes from one leg part to the otherthrough the waistband, and accordingly rigidity of the waistband is mostimportant.

As will be seen in FIGURE 6, the waistband is deepest from top to bottomat about the center of the back section since this portion thereof issubjected to the greatest bending moments in a vertical plane.

The brackets 16, previously referred to, are securely fixed to the sidesections of the waistband as by screws or bolts 30 and at their lowerends the brackets are provided with a re-entrant portion defining(FIGURE 2) slot means 32 to receive the bifurcated upper end 34 of avertically extending member 36 forming the upper end of the upper legpart 18. The arrangement is best seen in FIGURE 2 and provides means toreceive two sealed anti-friction vertically rotatable bearings 38between bracket 16 and member 36.

A hardened pin 39 receives the bearings of each leg member and issupported by bracket 16. The outer hearing races are suitably secured tothe bracket T6 with metal adhesive and therefore the bearings need notbe staked.

By spacing the bearings as shown at the hip joint they are ideallysituated to resist lateral loads imposed on the leg parts of the brace.This greatly increases the resistance of the brace against yielding andreduces the bearing loads such that free motion of the leg members ishad in front and back directions but substantially no side yieldingthereof occurs.

This particular point of orthopedic braces according to the prior artwas quite defective and it was not uncommen for braces to yield at thispoint, for the bearings to wear out and become loose, and for the braceto bend, permitting a scissors action of the legs of the user so thatone would catch to the other, thus inhibiting free leg movement and alsopreventing adequate balance training because of the narrowed supportarea of the feet which is thus occasioned.

According to the construction of the brace of the present invention,wherein side loading is resisted by a vertical couple acting through thebearings, thus perrnitting use of the full bearing capacity, thebearings have long-life, the leg portions move freely, and the strongrigid brackets 16 and their rigid connection with the extremely strongwaistband eliminates all of the weaknesses referred to above.

The brackets are suitably slotted at 31 to receive a conventionallocking means (not shown) in the form of a spring biased plunger whichcooperates with a slot in the bearing race to effect locking between thebracket i6 and part 18 through the agency of a handle referred tohereinafter.

The lower end of the member 36 extends into the upper end of the tubularportion an of the upper leg part 18. Member 36 is preferably finelyknurled as at 42. to inhibit movement thereof and in addition a clampingcollar 44 provides means for fixing tubular portion 44} thereto in anydesired position of adjustment. That part of tubular portion 46 which isnot occupied by the lower end of member 36 may advantageously be filledwith a light rigid foam such as isocyanate foam which will substantiallyprevent the wall of the leg member from collapsing even thoughoverloaded to the point of yielding.

At its lower end, leg part 18 comprises a bifurcated member 46 the upperend of which is advantageously riveted or more preferably cemented intothe lower end of the leg part 18 as by the metal adhesive indicated at48. Member 46 has a bifurcated lower end 49 and receives the upper endof tubular member 50 which is a portion of the lower leg part 22. Ananti-friction bearing 52 carried by member 59 and supported on pin 51provides a free moving, but extremely strong pivotal connection betweenmembers 46 and 50.

In the construction illustrated in FIGURES 1 and 2, member 50 isreceived in -a relatively short tubular element 54 and is clampedtherein by clamp collar 56 and, as in connection with member 36, member50 comprises knurling 58 to make its connection with tubular element 54more positive. The numeral 53 indicates a tubular member pinned orotherwise secured in member 54 and which may be extended or trimmed asdesired to provide the length suitable for a given application.

Spaced laterally from tubular element 54 is a tubular element 60, solocated as to be immediately inside the patients leg above the ankle.Tubular elements 54 and 60 are connected by an arcuate calf-engagingmetallic strip 62 which is fixed to the tubular elements in any suitablemanner, preferably by a metal adhesive or a combination of metaladhesive and rivets, although welding or any other suitable connectingmeans may be employed. This metallic strip preferably has the top andbottom edges thereon rolled as at 64 to eliminate sharp edges and alsoto provide for stiffening of the strip so that relatively thin metal canbe employed in its construction.

Tubular element 60 receives a member 66 which is clamped therein byclamp collar 68 which, at its lower end comprises the previouslyreferred to means 14 for pivotal connection with a rigid member in thepatients shoe.

The member to be incorporated in the patients shoe is illustrated at 70in FEGURE 7 and comprises a metallic plate adapted for fitting beneathor within the sole portion of the patients shoe and having laterallyspaced upstanding ears 72 which are bifuracted to receive the extrernelower ends of members 66 and which are apertured at 74- to receive pivotpins. The brace arrangement of FIGURES l and 2 requires only one of theupstanding ears 72 and the other thereof may be eliminated when thisbrace is used. The modification of FIGURE 8, however, engages both ofthe ears 72 when the brace is applied.

Returning to the upper leg part 18, between top and bottom thereof thereis mounted a thigh-engaging arcuate strap 76 adapted for engaging theback of the leg between the knee and the hip. Strap 76 likewise has itsedges rolled as at 78 to eliminate sharp edges and to provide greaterstrength even though the strap is made of relatively thin metal.

As will be seen in FIGURE 3, a preferred way of mounting strap '76 tothe upper leg portion is to wrap it therearound and use the rivet means80 to connect the wrapped around end to the strap. There is suitably ametal adhesive, such as the Epon resins utilized for joining metailair-craft parts, between the strap and the upper leg part to hold itfixedly in place thereon. Alternatively, rivets can be employed asindicated at 82 in FIG- URE 1, it being understood that such rivetswould be located as near to the neutral axis of the upper leg part 18 aspossible in order not materially to reduce the strength thereof.

In the modification of FIGURE 8, substantially an identical brace isillustrated except that instead of the strap portion 62 being inclineddownwardly toward the inside of the patients leg, as it is illustratedin FIGURES l and 2, the corresponding strap portion 83 extends straightacross and is connected by rivets 85 for example (or by spot welding ormetal adhesive) with a tubular member 84 extending downwardly toward theinside of the ankle of the patient and having mounted on the lower endthereof member 86 which will engage the inside one of the ears '72. ofthe member 70 in the patients shoe.

Also in FIGURE 8 the outer tubular element 54 is extended downwardly andhas fixed in its lower end member 88 adjustably clamped therein by clamp90 for engagement with one of the ears 72 of the member 70.

In utilizing the brace according to this invention, substantiallyconventional leather culfs and the like are employed about the waist andin connection with the straps passing about the legs. These leathercuffs, buckles, straps and laces are generally indicated at 92 inFIGURE 1. These are of a conventional material and form no integral partof the present invention.

Similarly, substantially conventional locking handle means 93 providedfor the upper leg parts are pivoted to the brackets 16; similar meansare provided where the upper and lower leg parts are pivoted together sothat the leg parts can be made rigid with the waistband when it isdesirable to permit the patient to stand.

As shown in FIGURE 1, the legs are in locked position; wire member 5secured to leg portion 18 and engaging the handle 93 of the lockingmeans may be drawn downwardly to engage in a groove or slot of thehandle to provide for retaining the handle in unlocked condition whensuch is desired.

According to this invention the upper leg part 18, when unloaded, flexessomewhat to the outside and which fiexure is indicated to an exaggerateddegree by the dotdash outline at 94 in FIGURE 2. Thus the load iscantilevered from the outside and this feature is very important becausethere is provided a predetermined degree of bias on the legs of thebrace when the brace is applied to a patient and this provides arestoring force which tends to draw the legs of the patient apart.

The entire brace structure according to the present invention is lightand strong, is readily producible by mass production methods, and can bequite closely fitted to the patient; the brace is readily adjustablewithin predetermined limits thus permitting the brace to be worn forquite a length of time, eliminating the necessity of the patient havingto be fitted frequently with new braces, which involves added expenseand inconvenience. Further, as the patient grows, new replacement partsmay be secured as required and the necessity for purchasing a completenew brace with each change in condition of the patient is eliminated.Moreover, the patient is not required to become accustomed to completelydifferent braces each time a new condition of growth and trainingoccurs. The brace parts are suitably interchangeable regardless of theage and condition of the patient.

It is to be particularly noted that the structure of the invention is sodesigned that the weight of the structure may be at a minimum for thesize or weight of the user. This stems not only from the selection oftubular strength members but from the fact that in use the leg partswill be substantially vertical and the bearings will be free to permitmovement in the desired forward and reverse direction while inhibitinglateral movement.

Somewhat more specifically, the brace as described may be sized to thepatient1 have found that braces currently in use weigh 8 to 12 poundsfor a child of about 35 pounds. With the construction of my inventionwhich attains the same or improved results the brace weight for a childof 35 pounds weight is reduced to 2 pounds 3 ounces. In general a weightreduction of at least 65% is attained over commercial braces when mystructure is employed.

The improved results particularly relate to the ease of training thepatient to walk. The bias on the patients legs adequately providesagainst contact between leg members when the patient moves. This alsopermits the patient to toe out in a normal manner and allows for theemployment of muscles and tendons which with the usual commercial bracesare quite out of use; thus the brace will aid recovery of the patient.

It will be understood that this invention is susceptible to modificationin order to adapt it to difierent usages and conditions and accordingly,it is desired to comprehend such modifications within this invention asmay fall within the scope of the appended claims.

I claim:

1. In an orthopedic brace, a waistband, a bracket secured to thewaistband and having a depending trifurcated portion, a leg memberhaving an upper bifurcated portion interleaved with the furcations ofsaid bracket, a pair of roller bearings mounted one within each of thefurcations of said leg member, the furcations of said bracket and legmember being pinned together through said bearings to provide anarticulated joint, whereby upon the application of transverse loading ofthe leg member a vertical couple is caused to act through the hearingsto counteract the transverse loading and permit fore and aft movement ofthe leg member.

2. In an orthopedic brace, a pair of leg members adapted to extendsubstantially vertically under loading, a waistband assembly bridgingthe leg members and jointed thereto at the upper ends thereof andadapted to transmit the loading from one leg member to the other in theutilization of the brace, each said leg member comprising tubularcircular cross-section elements, said leg members each comprising upperparts adapted to pass along the thigh of a wearer and lower partsadapted to pass along the calf of a wearer, said upper and lower partsbeing pivotally connected together, said leg members in the unloadedcondition being biased outwardly of a vertical position from its jointedconnection with the waistband, said lower parts each having means forsecuring the brace to a calf of the wearer to draw the leg memberstowards the vertical.

3. An orthopedic brace comprising a waistband, an outer leg memberpivotally jointed thereto, said outer leg member having a knee joint andterminating slightly therebelow, an inner leg member joined to the lowerextremity of the outer leg member by a calf-receiving means, said innerleg member terminating in a portion adapted to be connected in an anklejoint, whereby the vertical loading due to the weight of the wearer isreacted upwardly through the inner leg member, is ransterred to theouter leg member through the calfreceiving means and thence through theouter leg member to the waistband so that outward rolling force isapplied to the ankle of the wearer.

4-. An orthopedic brace comprising a waistband, a pair of outer legmembers bridged at the top by said waistband and pivotally joinedthereto, said outer leg members having knee joints and terminatingslightly therebelow, a pair of inner leg members associated one witheach of said outer leg members and joined to the lower extremitiesthereof by a calf-receiving means, said inner members terminating inportions adapted to be connected in an ankle joint, whereby the verticalloading due to the weight of the wearer is reacted upwardly through theinner leg members, is transferred to the outer leg members through thecalf-receiving means and thence through the outer leg members to thewaistband so that outward rolling force is applied to each ankle of thewearer.

5. An orthopedic brace having a waistband assembly with a portionthereof extending downwardly therefrom, a leg member, bearing meansarranged within said downwardly extending portion and pivotallyinterconnecting the leg member to the waistband assembly, said bearingmeans comprising two discrete horizontally spaced apart bearings withinsaid downwardly extending portion so arranged that upon the applicationof transverse loading of the leg member a vertical couple is caused toact through the bearing means to counteract transverse loading andpermit freedom of fore and aft movement of the leg member.

6. In an orthopedic brace, a waistband, a bracket secured to thewaistband and having a portion thereof depending below the waistband andprovided with reentrant portions, a leg member, and a pair of bearingmeans arranged in said reentrant portions of the bracket and rotatablein a substantially vertical plane pivotally connecting the leg memberand said depending portion of said bracket, said bearing means beingrestrained against lateral movement by said bracket and horizontallyspaced apart so that upon the application of transverse loading of theleg member a vertical couple is caused to act through the bearing meansto counteract the transverse loading and 7 permit freedom of fore andaft movement of the leg member.

7. An orthopedic brace comprising opposed leg members, a Waistbandcomprising a back portion and side portions extending forwardlytherefrom, said waistband being pivotally secured to the upper ends ofthe leg members, the Waistband being further of greatest cross-sectionat the joinder of the back and side sections, the leg members eachhaving means for securing the brace to the thighs and calves of apatient, each leg member in the unloaded condition being cantileveredoutwardly below the pivoted joint with the waistband to provide apredetermined degree of bias tending to draw the legs of the wearerapart and adapted to be drawn inwardly to a substantially verticalposition when the calf-securing means are engaged about a patient.

8. In an orthopedic brace, a waistband comprising an integral hollowedload-carrying member adapted to extend from hip to hip of the wearer andincluding a back section and side sections extending forwardly therefromand so shaped as to engage the waist of the wearer there- I of, and acellular elastomeric filler material substantially completely fillingthe hollowed portion of the member and reinforcing the load-carryingmember and adapted to maintain the spacing between the walls of theloadcarrying member.

9. In an orthopedic brace, a waistband comprising an integral hollowedload-carrying member adapted to extend from hip to hip of the wearer andincluding a back section and side sections extending forwardly therefromand so shaped as to engage the waist of the wearer thereof, and formedof opposed metal sections defining an interior chamber spacing, and arigid light Weight organic foam filler material filling the spacingbetween the walls of the load-carrying member.

10. In an orthopedic brace, a waistband comprising an integral hollowedload-carrying member adapted to extend from hip to hip of the wearer andincluding a back section and side sections extending forwardly therefromand so shaped as to engage the waist of the wearer thereof, and a rigidlight weight filler material reinforcing the load-carrying memberagainst collapse, the waistband being of greatest cross-section at thejoinder of the back and side sections.

11. In an orthopedic brace, a waistband comprising an integral hollowedload-carrying member formed of heat treated light metal and adapted toextend from hip to hip of the wearer and including a back section andside sections extending forwardly therefrom, and a rigid light weightfiller material within said hollowed member, said waistband being ofgreatest cross-section at the joinder of the back and side sections, andbeing vertically widest centrally thereof.

12. In an orthopedic brace, a waistband comprising interconnected backand side sections, with said side sections extending forwardly from theback section, and so shaped as to engage the waist of a wearer thereof,said waistband being formed of a core of cast isocyanate foam, a resinimpregnated fiber wrapping about said core and an outer coating ofplastic therearound.

13. The orthopedic brace of claim 12 wherein said waistband is ofgreatest cross-section at the joinder of the back and side sections.

14. An orthopedic brace for permitting to and fro movement of the limbsof the wearer comprising 21 waistband assembly, a leg member dependingfrom the waistband assembly, said leg member comprising upper and lowerparts, the upper part including strap means adapted to engage the thighand the lower part including strap means for engaging the calf, anarticulatable knee joint interconnecting the upper and lower parts, theupper part of said leg member including adjustable telescoping elementsdetachable each from the other, whereby the joint maybe aligned byvertical adjustment of the telescoping members to be juxtaposed to theknee joint of the wearer, and means provided by said leg member fordistributing forces urging the legs apart over an extended area of theupper and lower parts of the leg of the wearer.

15. An orthopedic brace of light weight but rigid constructioncomprising a waistband of hollowed structural cross-section, a legmember depending therefrom, the leg member having bearing meansconnecting the member with the waistband and forming a hip joint, saidleg member also having bearing means providing a knee joint, the legmember between the knee and hip joint comprising telescoping members atleast one of which is tubular, and havin clamping means associatedtherewith at the jointure with the waistband, said knee joint being thusadapted to be aligned to be juxtaposed to the knee joint of the wearerby vertical adjustment of the length of telescoping members, means foraffixing said leg member to the leg of the wearer, and means provided bysaid leg member for distributing forces urging the legs apart over anextended area of the leg of the wearer, the hollowed portion of saidwaistband and tubular leg member containing a lightweight reinforcingmaterial.

16. The orthopedic brace of claim 14 wherein the means for distributingforces urging the legs apart cornprises the leg member in the unloadedcondition being cantilevered outwardly'below the waistband assembly andabove the articulatable knee joint to provide a predetermined degree ofbias tending to draw the legs of the wearer apart, thereby distributingthe forces over an extended area.

References Cited in the file of this patent UNITED STATES PATENTS OTHERREFERENCES Orthopaedic Appliance Atlas; American Academy of OrthopaedicSurgeons, Inc. (1952); pg. 530. (Copy in Scientific Library.)

Orthopaedic Appliance Atlas, published in 1952 by the American Academyof Orthopaedic Surgeons, Inc; pp. 410, 414-15, 435 and 529. (A copy isin the Scientific Library.)

